There was no significant difference in major adverse events following pediatric and congenital catheterization cases with trainee involvement vs. cases without trainees; however, procedures with trainees saw slightly greater radiation exposure, contrast use and procedural length, according to a recent study published in JAHA.

Including 122,760 catheterizations from 107 academic hospitals captured between January 2011 and September 2020 by ACC's IMPACT Registry, Natalie Margaret Jayaram, MD, FACC, et al., sought to determine whether trainee presence had an impact on pediatric and congenital cardiac catheterization outcomes. There was a trainee present in 58% of cases.

Overall, major adverse event rates were similar, with 9% among trainee cases and 8% among cases without trainees. Even after multivariable adjustment, the rates remained similar (odds ratio, 1.06 [95% CI, 0.99-1.14], p=0.09).

Meanwhile, the authors identified an association between trainee presence and a 0.66 milligray/kg increase in radiation dose (95% CI, 0.44-0.88, p<0.001), a 0.034 cc/kg increase in contrast dose (95% CI, 0.005-0.06, p=0.02) and a 6.87 minutes longer procedural time (95% CI, 6.06-7.68, p<0.001).

"Although trainee presence was associated with slightly greater radiation exposure, contrast use and procedural duration, the magnitude of these differences was small," note the authors. "Thus, this study supports the safety of trainee involvement in pediatric and congenital cardiac catheterization procedures."